MEDICARE: ZORODZAI GUTU FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024185751	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194430116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZORODZAI GUTU FNP

Provider Business Mailing Address
First Line	:	PO BOX 791775
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21279-1775
Country	:	US
Telephone Number	:	571-302-5000
Fax Number	:	571-502-5001

Provider Business Practice Location Address
First Line	:	24801 PINEBROOK RD STE 110
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20152-4113
Country	:	US
Telephone Number	:	571-370-5538
Fax Number	:	571-370-5539

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2023
Last Update Date	:	05/06/2026

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Directions to “ ZORODZAI GUTU FNP” Practice Location

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